Individual provider Active NPI

Anthony Maurice Williams, MSN, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southgate, MI
National Provider Identifier
1265247688
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
S4704302940 Issued in MI
Practice address
13101 Allen Rd
Southgate, MI 48195-2216
Phone
(734) 785-7700
NPI assigned
Feb 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X S4704302940 MI Primary

Addresses

Primary practice location

13101 Allen Rd
Southgate, MI 48195-2216

Mailing address

28986 Applewood
Flat Rock, MI 48134-3400
Phone (313) 205-7896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
S4704302940MIMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1265247688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28986 APPLEWOOD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481343400",
            "telephone_number": "313-205-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13101 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952216",
            "telephone_number": "734-785-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANTHONY",
        "middle_name": "MAURICE",
        "credential": "MSN, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "S4704302940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.